PROVIDENCE FAMILY MEDICINE CLEMSON ROAD – NPI #1053605196
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

PROVIDENCE FAMILY MEDICINE CLEMSON ROAD is a provider located in COLUMBIA, SC. NPPES has assigned the NPI number 1053605196 to PROVIDENCE FAMILY MEDICINE CLEMSON ROAD on June 07, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PROVIDENCE FAMILY MEDICINE CLEMSON ROAD” is a dba name, the actual legal business name for this organization is AUGUSTINE HEALTH GROUP. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE FAMILY MEDICINE CLEMSON ROAD below.

NPI Profile for
AUGUSTINE HEALTH GROUP

NPI Number
1053605196
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AUGUSTINE HEALTH GROUP
Doing Business As (dba): PROVIDENCE FAMILY MEDICINE CLEMSON ROAD
Primary location
105 PROFESSIONAL PARK DRIVE
COLUMBIA, SC 29229
Phone: (803) 865-4780 Fax: (803) 865-4932
Mailing address
114 GATEWAY CORPORATE BLVD
SUITE 425
COLUMBIA, SC 29203-9740
Phone: (803) 865-4780 Fax: (803) 865-4932
Organization Subpart
Yes - PROVIDENCE FAMILY MEDICINE CLEMSON ROAD is subpart of another organization.
Authorized Official
ANGELA HAITHCOCK
CREDENTIALING COORDINATOR
Phone: (803) 865-4780
Updated
Identifiers

Identifiers for PROVIDENCE FAMILY MEDICINE CLEMSON ROAD

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERRAILROAD MEDICARE GROUP NUMBERSCDA2264
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 SC

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.